Individual provider · NPI-1

John Paul Gomez, NP

Nurse Practitioner, Psych/Mental Health · Middletown, NY

NPI number1477078095

StatusActive

Last updated in NPPESJul 24, 2019

Details

NPI: 1477078095
Entity type: Individual (NPI-1)
Name: John Paul Gomez
Credential: NP
Sex: Male
Sole proprietor: Yes
Enumeration date: Aug 4, 2017
Last updated: Jul 24, 2019

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
363LP0808X	Nurse Practitioner, Psych/Mental Health	402672	NY	Yes
163WG0000X	Registered Nurse, General Practice	708063	NY

Practice location

10 Benton Ave
Middletown, NY 10940-5177

Phone 845-563-8000

Mailing address

2570 Route 9w Ste 10
Cornwall, NY 12518-1370

Phone 845-220-3100 · Fax 845-534-2940

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